Ira Ted Webb Jr., PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110840810 Issued in VA

Practice address

105 Westwood CMN
Bluefield, VA 24605-2031

Phone

(276) 235-6232

Fax

(276) 250-5117

NPI assigned

Jun 13, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WV, VA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Merit-based Incentive Payment System (MIPS)

Final score

95.34 of 100Reported as apm

Quality

79.86

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ira.webb.1@30447.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• East River Psychiatry

  • Psychiatry Physician
  • Bluefield, VA
  • NPI 1689445884

  VA, WV

  Medicare reassignment
• Princeton Community Hospital Assn., Inc

  • Rural Health Clinic/Center
  • Bluefield, VA
  • NPI 1235446485
  NPD
• Epmg of Virginia P C

  • Emergency Medical Services (Emergency Medicine) Physician
  • Blacksburg, VA
  • NPI 1972545531
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1720021447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 12TH STREET EXT",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 WESTWOOD CMN",
            "city": "BLUEFIELD",
            "state": "VA",
            "postal_code": "246052031",
            "telephone_number": "276-235-6232",
            "fax_number": "276-250-5117"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1333 Southview Dr",
            "address_purpose": "LOCATION",
            "city": "Bluefield",
            "state": "WV",
            "postal_code": "24701",
            "country_code": "US",
            "telephone_number": "304-327-9205",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1333 Southview Dr",
            "address_purpose": "LOCATION",
            "city": "Bluefield",
            "state": "WV",
            "postal_code": "24701",
            "country_code": "US",
            "telephone_number": "304-327-9205",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 12th Street Ext",
            "address_purpose": "LOCATION",
            "city": "Princeton",
            "state": "WV",
            "postal_code": "24740",
            "country_code": "US",
            "telephone_number": "304-431-2869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEBB",
        "first_name": "IRA",
        "middle_name": "TED",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "762",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110840810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "001920236",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRGA",
            "identifier": "P00023341",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00023341",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Lee Tolliver, D.O.
• Jacenta Trigg
• Jerry Lee Turley Jr., PHARM D
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Westwood Family Medicine PLLC
• Westwood Medical Park Operations
• Westwood Medical Park Operations LLC
• Danise Conley White, OTRL
• Jodie Faith Whitlock

• All providers in Bluefield, VA
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.